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Disorders of the…

Autonomic nervous system

Approximately 33 percent of people experience a mild problem with motion sickness, whereas up to 66 percent experience motion sickness under extreme conditions, such as being on a tossing boat with no view of the horizon. Connections between regions in the brain stem and the autonomic system result in the symptoms of nausea, cold sweats, and vomiting.

The part of the brain responsible for vomiting, or emesis, is known as the area postrema. It is located next to the fourth ventricle and is not restricted by the blood–brain barrier, which allows it to respond to chemicals in the bloodstream—namely, toxins that will stimulate emesis. There are significant connections between this area, the solitary nucleus, and the dorsal motor nucleus of the vagus nerve. These autonomic system and nuclei connections are associated with the symptoms of motion sickness.

Motion sickness is the result of conflicting information from the visual and vestibular systems. If motion is perceived by the visual system without the complementary vestibular stimuli, or through vestibular stimuli without visual confirmation, the brain stimulates emesis and the associated symptoms. The area postrema, by itself, appears to be able to stimulate emesis in response to toxins in the blood, but it is also connected to the autonomic system and can trigger a similar response to motion.

Autonomic drugs are used to combat motion sickness. Though it is often described as a dangerous and deadly drug, scopolamine is used to treat motion sickness. A popular treatment for motion sickness is the transdermal scopolamine patch. Scopolamine is one of the substances derived from the Atropa genus along with atropine. At higher doses, those substances are thought to be poisonous and can lead to an extreme sympathetic syndrome. However, the transdermal patch regulates the release of the drug, and the concentration is kept very low so that the dangers are avoided. For those who are concerned about using “The Most Dangerous Drug,” as some websites will call it, antihistamines such as dimenhydrinate (Dramamine ® ) can be used.

Watch this video to learn about the side effects of 3-D movies. As discussed in this video, movies that are shot in 3-D can cause motion sickness, which elicits the autonomic symptoms of nausea and sweating. The disconnection between the perceived motion on the screen and the lack of any change in equilibrium stimulates these symptoms. Why do you think sitting close to the screen or right in the middle of the theater makes motion sickness during a 3-D movie worse?

Chapter review

The autonomic system is affected by a number of exogenous agents, including some that are therapeutic and some that are illicit. These drugs affect the autonomic system by mimicking or interfering with the endogenous agents or their receptors. A survey of how different drugs affect autonomic function illustrates the role that the neurotransmitters and hormones play in autonomic function. Drugs can be thought of as chemical tools to effect changes in the system with some precision, based on where those drugs are effective.

Nicotine is not a drug that is used therapeutically, except for smoking cessation. When it is introduced into the body via products, it has broad effects on the autonomic system. Nicotine carries a risk for cardiovascular disease because of these broad effects. The drug stimulates both sympathetic and parasympathetic ganglia at the preganglionic fiber synapse. For most organ systems in the body, the competing input from the two postganglionic fibers will essentially cancel each other out. However, for the cardiovascular system, the results are different. Because there is essentially no parasympathetic influence on blood pressure for the entire body, the sympathetic input is increased by nicotine, causing an increase in blood pressure. Also, the influence that the autonomic system has on the heart is not the same as for other systems. Other organs have smooth muscle or glandular tissue that is activated or inhibited by the autonomic system. Cardiac muscle is intrinsically active and is modulated by the autonomic system. The contradictory signals do not just cancel each other out, they alter the regularity of the heart rate and can cause arrhythmias. Both hypertension and arrhythmias are risk factors for heart disease.

Other drugs affect one division of the autonomic system or the other. The sympathetic system is affected by drugs that mimic the actions of adrenergic molecules (norepinephrine and epinephrine) and are called sympathomimetic drugs. Drugs such as phenylephrine bind to the adrenergic receptors and stimulate target organs just as sympathetic activity would. Other drugs are sympatholytic because they block adrenergic activity and cancel the sympathetic influence on the target organ. Drugs that act on the parasympathetic system also work by either enhancing the postganglionic signal or blocking it. A muscarinic agonist (or parasympathomimetic drug) acts just like ACh released by the parasympathetic postganglionic fiber. Anticholinergic drugs block muscarinic receptors, suppressing parasympathetic interaction with the organ.

Watch this video to learn about the side effects of 3-D movies. As discussed in this video, movies that are shot in 3-D can cause motion sickness, which elicits the autonomic symptoms of nausea and sweating. The disconnection between the perceived motion on the screen and the lack of any change in equilibrium stimulates these symptoms. Why do you think sitting close to the screen or right in the middle of the theater makes motion sickness during a 3-D movie worse?

When the visual field is completely taken up by the movie, the brain is confused by the lack of vestibular stimuli to match the visual stimuli. Sitting to the side, or so that the edges of the screen can be seen, will help by providing a stable visual cue along with the magic of the cinematic experience.

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Source:  OpenStax, Anatomy & Physiology. OpenStax CNX. Feb 04, 2016 Download for free at http://legacy.cnx.org/content/col11496/1.8
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